Fever of unknown origin: a systematic review of the literature for 1995???2004

Gaeta, Giovanni Battista; Fusco, Francesco Maria; Nardiello, S

doi:10.1097/00006231-200603000-00002

Cited by 99 publications

(78 citation statements)

References 25 publications

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“…White Indium 111 -labeled blood-cell scans and indium 111 Immunoglobulin-G have poor sensitivity and specificity, whereas Technetium scans seems to be more useful, owing to its high specificity (93-94%), but it has a poor sensitivity (40-75%) [77]. Finally, Fluorodeoxyglucose positron-emission tomography (FDG-PET) scans have a high sensitivity (95%) and a good specificity (88%) in identifying septic sources in patients with fever of unknown origin [77][78][79]. [80][81][82].…”

Section: The Diagnosis Of Sepsismentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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The reporting of infection/sepsis in chemo/radiation-treated head and neck cancer patients is sparse and the problem is underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of infections and sepsis. The Delphi appropriateness method was used for this consensus. External expert reviewers then evaluated the conclusions carefully according to their area of expertise. The paper contains seven clusters of statements about the clinical definition and management of infections and sepsis in head and neck cancer patients, which had a consensus. Furthermore, it offers a review of recent literature in these topics

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Section: The Diagnosis Of Sepsismentioning

confidence: 99%

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Mirabile

Numico²,

Russi

et al. 2015

Critical Reviews in Oncology/Hematology

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“…According to a recent review of the literature, about 25% of the cases of FUO remains without a precise diagnosis. 1 The aforementioned clinical case displays a classic FUO, with the presence of a potential diagnostic clue (the laboratory abnormalities of the liver enzymes) 2 that has induced the application of a target-oriented diagnostic algorithm, as suggested by international literature for the management of FUO, 3 and the execution of a liver biopsy, which in literature has proved to be a good diagnostic yield. 4 In any case, these proposed flow charts do not include the serological investigations of Q fever in the absence of a suggestive medical history, mainly the contact with animals.…”

Section: Discussionmentioning

confidence: 99%

From autoimmune hepatitis to Q fever

et al. 2015

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Case ReportL-V. M. is a 42-year-old man with unknown medical history except for obesity and an excessive consumption of alcohol and derived. He has come to our attention for a persistent fever, higher than 38°C, with chills, mainly but not exclusively in the evening, that lasted for more than 3 weeks. It was not associated with specific organ symptoms and in his past and recent medical history there were no clues to suspect a specific etiology, according to the most recent literature.1 No consumption of any drugs, over-the-counter products or narcotic substances were reported.Previously investigated at another hospital, the fever was associated with significant and persistent increases in enzymes of hepatic cytolisis and cholestasis (Table 1); serological investigations proved positive exclusively for rheumatoid factor (RF) and antismooth muscle antibodies (ASMA). The fever was responsive to a first antibiotic course with ceftriaxone (7 days) and to a following second antibiotic course with piperacillin-tazobactam (5 days), administered in two previous admissions. In both situations, there was a complete resolution of the fever followed by a new recurrence of the symptoms. The abdominal ultrasonography and abdominal magnetic resonance imaging/magnetic resonance cholangiography showed a picture of hepatic steatosis, without further morphological alterations.In our division, we confirmed the known defects of hepatic cytolisis and cholestasis; we found a significant increase in C-reactive protein in the absence of leukocytosis and of procalcitonin increase. Lymphocytes immunophenotyping was negative. Regarding autoimmunity, we found a positive low title for RF, lupus anticoagulant and anticardiolipin antibodies. We broadened our serological investigations with the observation of positive low title for Widal Wright reaction. The standard cultures (three sets of blood culture, urine culture, culture of sputum with special search for mycobacterium and oropharyngeal swab) were all negative. A chest X-ray and an echocardiogram were negative for pleuro-parenchymal lesions and for endocardial vegetations or masses. Our final diagnostic test was a liver biopsy.While waiting for the histological result, we started steroid therapy (dosage 1 mg/kg) in the suspect of an autoimmune disease. We got a full and stable defervescence, but only a partial reduction in hepatic enzymes of cytolisis and cholestasis and in C-reactive protein (Table 1). After two weeks we got the result of liver biopsy that reported the presence of steatosis with a severe lipogranulomatosis, with the indications to carry out further investigations in the setting of acquired diseases, above all infectious diseases.We performed additional microbiological tests, in- ABSTRACTQ fever is an infectious disease caused by Coxiella burnetii. Its clinical presentation is often nonspecific and the serological diagnosis difficult to make, especially in the absence of specific and suspected medical history. This article presents a case of fever of unknown origin (FUO),...

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“…Από τα αποτελέ σματα δυο πρόσφατων αναδρομικών μελετών φαίνε ται ότι η αιτιολογία του ΠΑΠ μπορεί να συνοψιστεί σε πέντε διαφορετικές κατηγορίες νοσημάτων και συ γκεκριμένα σε λοιμώδη (28%-36,6%), φλεγμονώδη μη λοιμώδους αιτιολογίας (15,9%-21%), νεοπλασμα- τικά (11,2%-17%), αταξινόμητα (10%-15%) και αδι ευκρίνιστα (19%-25%) (Mourad et al 2003, Gaeta et al 2006. Οι διαφορές στα ποσοστά των δυο μελετών αποδίδονται στην ανάλυση των δεδομένων διαφορε τικών πληθυσμιακών ομάδων.…”

Section: αιτιολογίαunclassified

Fever of unknown origin in the dog

Pardali

Adαmama-Moraitou

Rallis

2017

J Hellenic Vet Med Soc

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Fever of unknown origin (FUO) refers to a febrile syndrome that does not resolve spontaneously in an adequate period of time for the remission of self-limited infections and definitive diagnosis cannot be established despite considerable diagnostic effort. This definition is an extrapolation from human medicine, since FUO has not been still defined accurately in animals. The spectrum of diseases involved in FUO includes infectious, neoplastic, immune-mediated, miscellaneous and not defined diseases. Clients and clinicians must be aware that FUO may be a diagnostic challenge. The diagnostic plan should always begin with costless and simple tests followed by more invasive and expensive procedures. The initial diagnostic approach of FUO includes a detailed history, a thorough physical examination, a routine laboratory evaluation and radiographical examination of the thorax and abdomen. If diagnosis cannot be achieved, specific non-invasive tests should then be applied. No therapeutic trial should be initiated during evaluation, since it may alleviate clinical symptoms and alter the laboratory results potentially misleading the diagnostic approach. Nevertheless, fever is rarely harmful. In body temperature above 41,0 °C, diagnostic evaluation is postponed and the initiation of an emergency therapy is strongly recommended. If definitive diagnosis is confirmed, the dog is treated accordingly. Therapeutic trial is indicated, if despite the thorough evaluation no diagnosis is established or the owners are unwilling to support the cost of the diagnostic work-up of their dog. Therapy is focused on the administration of antibiotics followed by steroids and finally non-steroid anti-inflammatory drugs.

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Fever of unknown origin: a systematic review of the literature for 1995???2004

Cited by 99 publications

References 25 publications

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

Sepsis in head and neck cancer patients treated with chemotherapy and radiation: Literature review and consensus

From autoimmune hepatitis to Q fever

Fever of unknown origin in the dog

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